title: The concentration of high-sensitivity troponin I, galectin-3 and NT-proBNP substantially increase after a 60-km ultramarathon.
abstract: BACKGROUND
  The leading mechanisms responsible for the most prevalent and serious cardiac injuries include myocardiocyte stretch, myocardiocyte necrosis and cardiac fibrosis, which can now be reliably mirrored by measurement of natriuretic peptides, cardiospecific troponins and galectin-3, respectively. Although a large amount of knowledge has been gathered about the behavior and clinical significance of these biomarkers in patients with cardiac disorders, less information is available on their biology in paraphysiological conditions, including high-intensity endurance exercise.
  
  
  METHODS
  The study population consisted of 18 trained athletes, who performed a 60-km ultramarathon run. Blood was collected before the run (i.e., "baseline") and immediately after the end of the ultramarathon ("post-marathon") for measurement of serum high-sensitivity troponin I (TnI), NT-proBNP and galectin-3.
  
  
  RESULTS
  The concentration of all biomarkers measured in the post-marathon samples was remarkably increased as compared with the values obtained on baseline specimens. In particular, the median increase was 3.3 for TnI, 3.5 for NT-proBNP and 2.4 for galectin-3, respectively. The frequency of values exceeding the diagnostic threshold did not differ at baseline and after the ultramarathon for TnI (6% vs. 25%; p=0.15), instead was significantly increased for NT-proBNP (0% vs. 28%; p=0.016) and galectin-3 (0% vs. 67%; p<0.001). No significant correlation was found among the increase of any of the three biomarkers.
  
  
  CONCLUSIONS
  The results of this study demonstrate that high-intensity endurance exercise is associated with biochemical abnormalities that may reflect adverse consequences on cardiac structure and biology.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Salvagno
authors.forename: Federico
authors.initials: F
authors.lastname: Schena
authors.forename: Matteo
authors.initials: M
authors.lastname: Gelati
authors.forename: Elisa
authors.initials: E
authors.lastname: Danese
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cervellin
authors.forename: Gian Cesare
authors.initials: GC
authors.lastname: Guidi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D037502:Galectin 3 / Q000097:blood*; D006335:Heart Injuries / Q000175:diagnosis*; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012420:Running; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain